Avoidant, Dependent, and Obsessive-Compulsive Personalities

Avoidant, Dependent, and Obsessive-Compulsive Personalities

Diagnostic Criteria

Facts about Avoidant Personality Disorder

Treatment for

Avoidant Personality Disorder

In order to be diagnosed, 5 or more of the following symptoms must be present:

1. Difficulty making decisions without advice from others

2. Needs others to assume responsibility for most major areas of their life

3. Has difficulty expressing disagreement with others due to fear of loss of support

4. Has difficulty initiating projects, or doing things on his or her own

5. Goes to excessive lengths to obtain support and approval of others

6. Feels uncomfortable/helpless when alone due to exaggerated fears of being able to care for his or herself

7. Urgently seeks another relationship as source of support when a close relationship ends

8. Is unrealistically preoccupied with fears of being left to take care of himself or herself

Prevalence

• Approximately 2.5% of Americans have Avoidant Personality Disorder

• Up to 10% of people in outpatient clinics have this disorder

• CBT that uses exposure to avoided stimuli and cognitive restructuring is preferred
• Family or couples therapy may also be used to change responses to maladaptive behavior

Comorbidity

• Comorbidity with social phobia is very high due to the overlap of diagnostic criteria between the two disorders
• Other common comorbid personality disorders include dependent personality disorder, borderline personality disorder, and cluster A disorders

Dependent Personality Disorder Treatment

• Long-term psychotherapy is typically used
• Medications may also be given to help with specific debilitating symptoms such as anxiety or depression

Onset

Dependent Personality Disorder

• Symptoms such as shyness or fear of strangers and new situations must emerge by early adulthood

Course

• Approximately 50% of people with Avoidant Personality Disorder improve with treatment 2 years after diagnosis

Causes of Dependent Personality Disorder

• The exact cause of Dependent Personality Disorder is unknown
• Chronic physical illness or Separation Anxiety Disorder in childhood or adolescence may predispose an individual to the development of this disorder
• Overprotective parenting may also lead to the development of this disorder

• Characterized by submissive and clingy behaviors, based on fear of seperation.
• These behaviors are intended to elicit attention and reassurance.
• People with Dependent Personality Disorder are plagued by self-doubt and have a difficult time making their own decisions.

Facts about Dependent Personality Disorder

• Prevalence of dependent personality disorder in the American population is less than 1%
• Common comorbid personality disorders are avoidant, borderline and histrionic personality disorders
• Symptoms must emerge by early adulthood
• Symptoms may improve over time to the point of an individual no longer meeting diagnostic criteria of the disorder
• Women tend to be diagnosed more commonly than men

What is a personality disorder?

Causes of Avoidant Personality Disorder

• The exact cause of the disorder is unknown
• It is suspected that the amygdala is involved in development of this disorder
• Temperament can also contribute to the development of Avoidant Personality Disorder

Obsessive-Compulsive Personality Disorder Facts

• Approximately 2-8% of the population has obsessive-compulsive personality disorder, making it the most prevalent personality disorder
• The diagnostic criteria specify that symptoms must occur by early adulthood
• Most people with OCD do not have obsessive-compulsive personality disorder
• Symptoms of up to one third of patients improve over time to the point of no longer meeting the diagnostic criteria
• Twice as many men suffer from obsessive-compulsive personality disorder as women

• A deeply ingrained maladaptive pattern of behavior which causes long term difficulties in relationships or functioning in society.

• The DSM-5 recognizes 10 different personality disorders, grouped into clusters.

• Avoidant, Dependent, and Obsessive-Compulsive personality disorders belong to cluster C, anxious/fearful cluster.

Obsessive-Compulsive Personality Disorder

Avoidant Personality Disorder

Treatment

• Characterized by long standing feelings of inadequacy and sensitivity to rejection
• Predominant characteristic is social inhibition
• Individual is hypervigilant for any indication of criticism or rejection
• Because of this, an individual will attempt to avoid any social interaction

• Characterized by preoccupations with perfectionism, orderliness, and self-control as well as low levels of efficiency and flexibility
• Details are so important to a person with Obsessive-Compulsive personality disorder that decision making can become an extremely long process
• Some, but not all workaholics have this disorder
• Relationships with someone who has this disorder are normally formal and rigid, focusing on logic and intellect

• CBT and techniques that improve a person's insight can be helpful. The goal of this type of therapy is to lessen rigid expectations and value relationships and recreation with less emphasis on work
• Selective Serotonin Reputake Inhibitors (SSRIs) may be used in addition to psychotherapy to help individuals with obsessive-compulsive personality disorder to be less bogged down by details
• Breathing and relaxation techniques may be useful in reducing levels of stress and the sense of urgency experienced with this disorder

Diagnostic Criteria

In order to be diagnosed with Avoidant

personality disorder an individual must present 4 of the following symptoms:

1. Avoids occupational activities that involve significant interpersonal contact

2. Is unwilling to get involved with people unless certain of being liked

3. Shows restraint within intimate relationships

4. Is preoccupied with being criticized or rejected in social situations

5. Is inhibited in new interpersonal situations because of feelings of inadequacy

6. Views self as socially inept, unappealing or inferior to others

7. Is unusually reluctant to take personal risks or engage in new activities

Diagnostic Criteria

Obsessive-Compulsive Personality Disorder vs. Obsessive Compulsive Disorder

• People with Obsessive Compulsive Personality Disorder do not have obsessions and compulsions, they are preoccupied with details
• People with OCD are aware of their unwanted thoughts, however people with Obsessive Compulsive Personality Disorder are inflexible and believe their way is the "right and best way"
• OCD usually impairs an individual's ability to function at work, but Obsessive Compulsive Personality Disorder can assist in more efficient work skills

In order to be diagnosed with Obsessive-Compulsive Personality Disorder, 4 or more of the following symptoms must be present:

1. Is preoccupied with details, rules, lists, order or schedules to the extent that the major point of the activity is lost

2. Shows perfectionism that interferes with task completion

3. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not out of economic necessity)

4. Is overconscientious and inflexible about matters of morality, ethics or values

5. Is unable to discard worn-out or worthless objects even when they contain no sentimental value

6. Is reluctant to delegate tasks or work with others unless they submit to exactly his or her way of doing things

7. Money is viewed as something to be hoarded for future catastrophes

8. Shows rigidity and stubbornness

Causes of Obsessive-Compulsive Personality Disorder

• The exact cause of this disorder is unknown, however most professionals subscribe to a biopsychosocial model of causation
• Social factors include how an individual interacts in their early development with their family and other children
• Psychological factors include a person's personality and temperament, shaped by the environment and learned coping skills to deal with stress